Chronic patients: persons with diabetes frequent attenders in Croatian family practice

Scientific paper - Original scientific paper

• Author: Marija Vrca Botica
• Author: Luka Kovačić
• Author: Milica Katić
• Author: Hrvoje Tiljak
• Author: Ivana Pavlić Renar
• Author: Iva Botica
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Chronic diseases cause high frequency visits and generate the long-term frequent attenders (FAs). The connection between frequent attendance and specific morbidities in the health care systems in transitional Europe has been underestimated. We investigated whether frequent visits of chronic patients in primary care are related to characteristic of chronic disease (diabetes mellitus) and whether this is influenced by the family practice in the transitional health care. We analyzed the number of visits a day time work for 490 persons with diabetes in the period 1997 to 2000. As the cut-off points between frequent attenders and non frequent attenders (NFAs) we used the value of the third quartile (Q3) of visits determined for the sex and age groups in the parallel study in the whole population. The analysis was performed for 23 variables: demographic characteristics of patients, disease characteristic and variables of physician. Logistic regressions were employed to identify the predictors of FAs/NFAs. 56.9% (in 1997) to 62.4% (in 2000) persons with diabetes were FAs, compared to 22.4% to 24.3% FAs patients in the whole population. Logistic regression analysis significantly differentiated the two group of visits with 68% accuracy. 4 variables are significant predictors for FAs/NFAs: diabetes as the main disease (p = 0.0005), diet-only-treatment (p = 0.0062), treatment by secondary care (p = 0.0116), and if glycated hemoglobin test (HbA1c) is determined (p = 0.0272). Understanding the similarities and differences of FAs/NFAs persons with diabetes may be important in improving the care and management of chronic diseases in family medicine in transitional health care systems.

Abstract (croatian)

Kronične bolesti su čimbenik za veliki broj dugotrajnih učestalih posjetioca u obiteljskoj medicini. Nije dovoljno istražen učestali posjetilac – kronični bolesnik u tranzicijskim zdravstvenim sustavima u Europi. Istražili smo osobine kroničnog bolesnika-učestalog posjetioca, osobu s šećernom bolesti u uvjetima tranzicijskog zdravstvenog sustava. Analizirali smo ukupni broj posjeta: 490 osoba s šećernom bolesti, obiteljskom liječniku u razdoblju od 1997. do 2000. godine. Kao točku razgraničenja između učestalog-neučestalog posjetioca uzeli smo broj posjeta – vrijednost treće kvartile (Q3), određenu u paralelnoj studiji u općoj populaciji za šest dobno spolnih skupina. Ispitane su 23 nezavisne varijable: demografske karakteristike pacijenta, varijable dijabetesa i pridruženih bolesti i varijable prakse. Primijenjena je logistička regresija za određivanje prediktornih čimbenika za obilježje učestali-neučestali posjetilac između nezavisnih varijabli. Prema vrijednosti (Q3) u općoj populaciji, od 56,9% (u 1997.) do 62,4% (u 2000.) osoba s šećernom bolesti su učestali posjetioci, u usporedbi s 22,4% do 24,3% učestalih u općoj populaciji u istim dobno-spolnim skupinama. Logistička regresijska analiza grupira bolesnike u dvije grupe: učestali-neučestali posjetilac, s 68% točnosti. 4 varijeble imaju statistički značajnu predikciju za obilježje učestali-neučestali posjetilac: dijabetes kao glavna bolest (p=0,0005), ako je bolesnik samo na osnovnim principima liječenja (p=0,0062), ako se bolesnik liječi u sekundarnoj zdravstvenoj zaštiti, (p=0,0116), i ako u provođenju zaštite za promatranu godinu ima određen HbA1c (p=0,0272). Prema nađenim čimbenicima koji razlikuju dijabetičkog bolesnika učestalog od neučestalog posjetioca, pružanje zdravstvene zaštite kroničnom bolesniku u uvjetima tranzicijske obiteljske medicine može biti bitan čimbenik za učestalog posjetioca kroničnog bolesnika.

• Keywords (english): Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 2 - epidemiology; Family Practice - statistics & numerical data; Adult; Aged; Aged, 80 and over; Chronic Disease; Comorbidity; Croatia - epidemiology; Female; Humans; Male; Middle Aged
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 31, no. 2, pp. 509-516
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:753962
• Publication: 2007-06
• Document URL: https://hrcak.srce.hr/27375
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 10:56:11